Introduction Hepatitis B (HBV) infection is a major cause of chronic liver disease, which is a leading cause of death worldwide. Despite differing epidemiology, HBV infection shares routes of transmission with HIV infection. Therefore we explored factors associated with those infections among high-risk populations in Peru.
Methods Men who have sex with men (MSM) and transwomen (TW) recruited from two STI clinics completed a behavioural survey on alcohol use and sexual risk-taking in the last 3 months and received HIV testing. An AUDIT score ≥17 determined the presence of a severe alcohol use disorder. Active hepatitis B infection was determined by detection of HBsAg using EIA UMELISA and HBsAg confirmatory testing (Tecnosuma, Cuba). Self-collected rectal swabs were used to diagnose gonorrhoea/chlamydia by NAAT. Prevalence ratios (PR) were calculated using Poisson regression.
Results Among 310 MSM and 89 TW (median age 30 years, IQR: 18–58), 5% (20/399) had active HBV infection. Of the 20 participants with active HBV infection, 50% were HIV co-infected which was significantly more than the HIV prevalence among HBsAg negatives (30%, p-value = 0.053). Rates of recent condomless anal intercourse were similar by HBV infection status (68% among those with active infection vs. 74% among HBsAg negatives p = 0.557). Rectal STI prevalence was 40% among participants with active HBV infection vs. 20% among HBsAg negative participants. (p-value = 0.034). In multivariable regression active HBV infection was associated with severe alcohol use disorders (aPR = 2.54, p-value = 0.008) and HIV diagnosis (aPR = 2.56, p-value = 0.009).
Conclusions In the context of South America’s low carrier rate, the prevalence of active HBV infection among this Peruvian sample is high. Our findings emphasise the importance of revising national HBV screening and vaccination guidelines to include HIV-infected individuals and heavy drinkers since both conditions may accelerate liver disease. Educational campaigns to encourage transmission prevention are also needed since condomless anal intercourse was common in this cohort.
Disclosure of interest statement This data for this abstract was obtained from an NIH-funded study (1R01AI099727). Hepatitis tests were donated however the donating company did not contribute to the conception of this study or participate in the analysis/interpretation of the data in this abstract.